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Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma

  • Authors:
    • Kenji Kuroda
    • Shinsuke Tasaki
    • Junichi Asakuma
    • Akio Horiguchi
    • Keiichi Ito
  • View Affiliations / Copyright

    Affiliations: Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359‑8513, Japan
    Copyright: © Kuroda et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 102
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    Published online on: March 13, 2021
       https://doi.org/10.3892/mco.2021.2264
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Abstract

It has been previously indicated that preoperative plasma fibrinogen levels can correlate with cancer progression and be used as a useful predictor of lymph node metastasis or its premetastatic status such as lymphovascular invasion (LVI). In the present study, how preoperative plasma fibrinogen levels, considered in conjunction with other clinicopathological factors, can predict the presence of LVI and prognosisin patients with upper urinary tract urothelial carcinoma (UTUC) was examined. Medical records of 145 patients with UTUC who underwent radical nephroureterectomy (RNU) were retrospectively reviewed. The current study evaluated systemic inflammatory response markers including levels of plasma fibrinogen and other clinicopathological factors in orderto determine independent predictors of LVI and prognosis. The Cox proportional hazards model indicated that positive surgical margins and LVI were independent factors for poor cancer‑specific survival (CSS) rates and extraurothelial recurrence‑free survival (ERFS) rates. In addition, positive cytology, the presence of hydronephrosis and plasma fibrinogen levels were significant preoperative predictors of LVI. Furthermore, patients exhibiting two or more of higher fibrinogen levels (≥400 mg/dl), positive urine cytology and the presence of hydronephrosis were indicated to exhibit worse CSS or ERFS rates compared with patients exhibiting only one of the aforementioned factors or those with none of the three aforementioned factors in the multivariate analysis of the Cox proportional hazards model. In conclusion, hyperfibrinogenemia can be an independent predictor of the presence of LVI, and stratifying preoperative risk using fibrinogen levels, urine cytology and hydronephrosis can serve as the basis for selecting candidates for additional therapy before and/or after RNU in patients with UTUC.
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Copy and paste a formatted citation
Spandidos Publications style
Kuroda K, Tasaki S, Asakuma J, Horiguchi A and Ito K: Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma. Mol Clin Oncol 14: 102, 2021.
APA
Kuroda, K., Tasaki, S., Asakuma, J., Horiguchi, A., & Ito, K. (2021). Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma. Molecular and Clinical Oncology, 14, 102. https://doi.org/10.3892/mco.2021.2264
MLA
Kuroda, K., Tasaki, S., Asakuma, J., Horiguchi, A., Ito, K."Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma". Molecular and Clinical Oncology 14.5 (2021): 102.
Chicago
Kuroda, K., Tasaki, S., Asakuma, J., Horiguchi, A., Ito, K."Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma". Molecular and Clinical Oncology 14, no. 5 (2021): 102. https://doi.org/10.3892/mco.2021.2264
Copy and paste a formatted citation
x
Spandidos Publications style
Kuroda K, Tasaki S, Asakuma J, Horiguchi A and Ito K: Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma. Mol Clin Oncol 14: 102, 2021.
APA
Kuroda, K., Tasaki, S., Asakuma, J., Horiguchi, A., & Ito, K. (2021). Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma. Molecular and Clinical Oncology, 14, 102. https://doi.org/10.3892/mco.2021.2264
MLA
Kuroda, K., Tasaki, S., Asakuma, J., Horiguchi, A., Ito, K."Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma". Molecular and Clinical Oncology 14.5 (2021): 102.
Chicago
Kuroda, K., Tasaki, S., Asakuma, J., Horiguchi, A., Ito, K."Preoperative risk stratification using plasma fibrinogen levels can predict lymphovascular invasion and poor prognosis in patients with upper urinary tract urothelial carcinoma". Molecular and Clinical Oncology 14, no. 5 (2021): 102. https://doi.org/10.3892/mco.2021.2264
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